Questions on the Diep Flap procedure

[Bexley103]

Last month, I had a simple mastectomy with no reconstruction. Due to timing and the stress of my breast cancer diagnosis, I chose to wait to have reconstruction after an adjuvant therapy that I would need. Next month, I will begin what will be about 5 months of chemo. In the meantime, I am going to have genetic testing to find out if I am predisposed to BRCA. If I am predisposed, I will probably have my other breast removed.

I spoke with a plastic surgeon about my reconstruction options. The Diep flap procedure is the most appealing to me, but have a couple of questions that I am hoping you will be able to answer for me:

* I understood that the Diep flap procedure used fat from the belly. Subsequent readings tell me that the fat may come from the backside. Which is the more typical procedure, and does it depend on the amount of fat on the woman?
* What is the typical healing time for the diep flap procedure? How long should someone expect to be away from work? How long before someone might be able to travel?
* Is any physical therapy required for the healing process? Or are there simple exercises that one days (like the post-mastectomy exercises)?
* If I choose to have the other breast removed at the same time, would I have the drainage tube again?
* How long would I need to wait after chemo for the surgery?

Thank you.

[Archibald S Miller III, MD,FACS]

The diep procedure is a free flap from the anterior abdomen that spares the muscle from the rectus area. It is a very good procedure in the right hands and yields about a 90 % success rate. 10 % of the flaps fail. That means the flap dies and it will require a new procedure. There are not many doctors doing this procedure, and one must be careful to choose those who do a lot of these to get a good result. There are other alternatives that give excellent results that you may want to consider. Please consult a board certified reconstructive surgeon to give you advice. Thank you,

            arch s miller ms md facs

[penguin69]

I hope someone answers this, i have many of the same quesitons.  I've done a BIT of research, and I do understand that when they take the fat from the buttocks, the surgery is obviously done on both front and back of your body, requiring some finesses and 'flipping' during the surgery.  I can only imagine that in recovery, laying on either your back OR your front might be painful.

I have only begun my research, first appt. w/plastic surgeon next week.  My situation is a bit different....I was diagnosed w/LCIS in 2003 after a surgical biopsy as the stereotactic could not get the section.  Since then, we are cautiosly watching my dense fibrous breasts, and they are continually chaning.  I've had 4 core needle biopsies, another sterotacic.  Last 3 months, I've had 4 wire guided ultrasound, and another sterotactic.  Now I have atypical papilloma (single).  I can't take the stress of going thru this every 3 months.  Plus, I feel like I am being carved up bit by bit, so now am committing to a double mystectomy.  So, anyone else out there...

implants vs. flaps
implants - what types?
follow up issues
well...everything i suppose!

thanks all!